Dr Lindsey Nicholls

Senior Lecturer
School of Health and Social Care
Dr Lindsey Nicholls



I have worked as a clinical occupational therapist (OT), organisational consultant and academic in Cape Town, South Africa and London, UK. My undergraduate degree in OT was from the University of Cape Town and MA from the University of East London / Tavistock-Portman Clinic in psychoanalytic work with organisations. My PhD research involved a psychoanalytically informed ethnographic study of the social defence mechanisms used by occupational therapists in their professional work. I have published articles, chapters and co-authored a book on psychoanalytic thinking in occupational therapy and my current academic interests are in the use of dreams to extend clinical reasoning / reflexivity and in the symbolic understanding of occupations in clinical work and social life. I am a committed educationalist and value the use of dialogue and debate through the use of seminars and e-learning forums, which can engage students in examining their underlying assumptions about health, illness and the ‘other’. This approach to learning can encourage students to consider the deeper (or hidden) social issues which may affect the occupational engagement of individuals or groups in different communities. It is through this work of reflecting on hidden assumptions and desires that students and novice clinical therapists are able to connect with their authentic compassion. This emotional recognition of the necessary dependency in any relationship can move beyond a (superficial) moral need to ‘do good for the other’ to a deeper ethical commitment to social justice.


  • PhD University of the West of England, (2010)


University of Essex

  • Subject Lead Occupational Therapy, University of Essex (1/1/2018 - present)

Other academic

  • WPF MA proposal lecturer, Psychoanalysis, University of Roehampton (2/10/2015 - 31/7/2019)

  • Theory Lecturer D10 course, Tavistock and Portman Training, University of Essex (29/9/2011 - 29/6/2019)

Research and professional activities

Research interests

‘Putting it Into Words’; A Psychoanalytically Orientated Ethnographic Study of Hospital Based Clinical Occupational Therapy Departments in the UK and South Africa.’

Occupational therapists that care for vulnerable clients in acute medical (i.e. clinical) settings need to use sound clinical reasoning and be emotionally sensitive to the client’s anxiety about a change in their health status and/or grief over their loss of independence. Research into nursing termed this psychologically demanding relationship work as ‘emotional labour’ (e.g. Smith, 1992 and Theodosius, 2008). This paper explores the stated and implicit reasons why therapists chose the work they did. The research was an ethnographic study that was inspired by the psychoanalytic organisational research undertaken by Menzies Lyth (1988), and was aimed at understanding the social defences that therapists used to protect themselves from the emotionally distressing aspects of their work. These unconscious mechanisms may have protected professionals from the anxiety of working with vulnerable clients but could have thwarted therapists’ fulfilment of their deeper unconscious reparative desires, which may have motivated them to working in a caring profession. The psychoanalytically informed study was undertaken in two clinical occupational therapy departments in a first and third world country (the UK and South Africa respectively). Three linked data gathering methods were used; participant observation, free association narrative interviews and inquiry groups. The analysis of the data incorporated reflexive accounts by the researcher, including the researcher’s and participants’ dreams.

Open to supervise

psychoanalytic thinking in organisations

How can the culture of an institution or organisation be understood? What social, political, historical and personal histories do organisations carry? Researching beneath the surface dynamics.

Key words: action research
Open to supervise

Therapeutic use of self in clinical practice

The therapeutic use of self has been a cornerstone of practice in many of the health sciences and yet it has been under theorized by using terms such a 'client/person centered' practice. This concept does not always take into account the need to provide containment and 'holding' in a relationship with a client. These processes are the measure of relatedness in therapy, by using concepts of transference and countertransference both conscious intentions and unconscious communication can be considered.

Key words: empathy
Open to supervise

Conferences and presentations

We should all be Feminist Occupational Therapists,

RCOT Conference, Royal College of occupational therapy annual conference, Birmingham, United Kingdom, 17/6/2019

Same As, Similar to or Different From; negotiating relationships in narrative research’

Association of Psychosocial Studies (APS) Conference, APS conference 2019, London, United Kingdom, 17/5/2019

Inability to Mourn; racism, shame and grief’

World Federation Occupational Therapy (WFOT), WFOT Conference, Cape Town, South Africa, 17/5/2018

Only Connect’; the art of psychoanalytic playfulness in occupational engagement’

World Federation Occupational Therapy, WFOT, Cape Town, South Africa, 16/5/2018

Researching beneath the surface

Invited presentation, Italian Occupatonal Therapy conference, Milan, Italy, 30/9/2017

Teaching and supervision

Current teaching responsibilities

  • Concepts of Therapy (HS176)

  • Professional Reasoning (HS272)

  • Advancing Occupational Therapy Practice (HS371)

  • Professional Reasoning in Practice (HS801)

  • Foundations for occupational therapy (HS892)

  • Advancing Professional Practice in Occupational Therapy (HS894)

  • The thinking therapist (HS896)

  • Psychoanalysis of Groups and Organisations (PA927)


Journal articles (10)

Nicholls, L., Discomforting and Disquieting: Dreaming to Enhance Reflexivity. Journal of Psycho-Social Studies. 10 (1), 25-46

Swenson, R., Alldred, P. and Nicholls, L., (2022). Doing gender and being gendered through occupation: Transgender and non-binary experiences. British Journal of Occupational Therapy. 85 (6), 446-452

Nicholls, L. and Elliot, ML., (2021). Authors in dialogue - Why race matters: Then, now and for the future. Journal of Occupational Science. 28 (3), 419-422

Nicholls, L., (2021). Researching the unconscious: principles of psychoanalytic method. Journal of Social Work Practice. 35 (2), 226-228

Franco, L. and Nicholls, L., (2021). Healing the ‘split’: trauma as a dynamic in psychosis. Journal of Psychosocial Studies. 14 (2), 153-161

Nicholls, L. and Elliot, ML., (2019). In the shadow of occupation: Racism, shame and grief. Journal of Occupational Science. 26 (3), 354-365

Leibowitz, B., Bozalek, V., Carolissen, R., Nicholls, L., Rohleder, P. and Swartz, L., (2010). Bringing the social into pedagogy: unsafe learning in an uncertain world. Teaching in Higher Education. 15 (2), 123-133

Swartz, L., Rohleder, P., Bozalek, V., Carolissen, R., Leibowitz, B. and Nicholls, L., (2009). ‘Your Mind is the Battlefield’: South African Trainee Health Workers Engage with the Past. Social Work Education. 28 (5), 488-501

Nicholls, L., (2008). Touching the void’. Mountains as transitional objects: Climbing as a defence against anxiety. Psychodynamic Practice. 14 (3), 249-262

Nicholls, L., (2006). When Faith Eclipses Hope: Forgiveness within Reparation. Organisational and Social Dynamics. 6 (2), 161-182

Books (3)

Leibowitz, B., Swartz, L., Bozalek, V., Carolissen, R., Nicholls, L. and Rohleder, P., (2013). Community, Self and Identity Educating South African University Students for Citizenship. HSRC Press. 0796923981. 9780796923981

Nicholls, DL., Piergrossi, JC., Gibertoni, CDS. and Daniel, MA., (2013). Psychoanalytic Thinking in Occupational Therapy. Wiley. 0470655860. 9780470655863

Nicholls, L., Piergrossi, JC., Daniel, M. and Gibertoni, CDS., (2013). Introduction. John Wiley & Sons, Ltd. 9780470655863

Book chapters (8)

Nicholls, L., (2018). Seeing is Believing, Dreaming is Thinking; Mapping of Methodological Viewpoints’. In: Researching Beneath the Surface Psycho-Social Research Methods in Practice. Routledge. 0429918569. 9780429918568

Nicholls, L., (2013). Introduction. In: Psychoanalytic Thinking in Occupational Therapy. John Wiley & Sons. 1- 11. 0470655860. 9780470655863

Nicholls, L., (2013). Psychoanalytic Thinking in Research. In: Psychoanalytic Thinking in Occupational Therapy. John Wiley & Sons. 165- 185. 0470655860. 9780470655863

Nicholls, L., (2013). The ‘Therapeutic Use of Self’︁ in Occupational Therapy. In: Psychoanalytic Thinking in Occupational Therapy. John Wiley & Sons. 15- 31. 0470655860. 9780470655863

Nicholls, L., (2013). Working with Difference. In: Psychoanalytic Thinking in Occupational Therapy. John Wiley & Sons. 145- 161. 0470655860. 9780470655863

Nicholls, L. and Rohleder, P., (2012). A Pedagogy of hope: Learning about community, self and identity with students in the social and allied health sciences. In: Higher education for the public good: Views from the south. Editors: Leibowitz, B., . Trentham Education

Nicholls, L. and Rohleder, P., (2012). ‘A Pedagogy of Hope; Learning about Community, Self and Identity with Students in the Social and Allied Health Sciences’. In: Higher Education for the Public Good Views from the South. AFRICAN SUN MeDIA. 1920338888. 9781920338886

Nicholls, L., (2009). Seeing. believing, dreaming. thinking: Some methodological mapping of view points. In: Researching Beneath the Surface: Psycho-Social Research Methods in Practice. Routledge. 169- 192. 9781855756182

Grants and funding


Teaching theory on course and supervision of a professional doctorate (D10 and D10D): Psychodynamic and system approaches to organisations

Tavistock and Portman NHS Foundation Trust


Teaching theory on course known as D10, MA: Psychodynamic and system approaches to organisations.

Tavistock and Portman NHS Foundation Trust

+44 (0) 1206 876370


2S2.3.19, Colchester Campus